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Table 5 Cataract care

From: Exploring types of focused factories in hospital care: a multiple case study

Unit

11

12

13

Organizational context

   

Focusing decisions/operations strategy

Strategy pursuing efficiency

Strategy to reduce the no. of visits in order to realize lead time ≤ 18 weeks

Strategy pursuing open access, prevent medical liability

Standardized procedures

Yes

Yes

Yes

Dedicated lay-out

Cataract clinic with dedicated day-surgery operating rooms

Cataract clinic with dedicated day-surgery operating rooms

Clinic applied general operating rooms

Planning routine

One stop diagnostics and scheduling of surgery

Preoperative assessments according to open access model

One stop diagnosis, preoperative assessment and scheduling of surgery

One stop diagnosis, preoperative assessment and scheduling of surgery for clinic patients

Most diagnostics (91% of the patients) take place outside the hospital at the practice of affiliated ophthalmologists

Team composition

Extensive division of labor allocating tasks to nurses

Extensive division of labor allocating tasks to nurses

MDs perform most tasks

Degrees of focus

   

Product focus

94%

94%

94%

Process focus

84%

84%

84%

Operational performance

   

Visits/patient

3.2

3.0

3.6

Lead time (days)

91.0

109.2

15.0

   - Access time to outpatient clinic

25.0

31.5

0.0

   - Waiting time for surgery

66.0

77.7

15.0

  1. The organizational outcomes for unit 13 exclude diagnostics (as these take place outside the hospital). If these outside diagnostics were taken into account, the degree of focus score on process focus could deteriorate to 78% or 72%